Lifeline regular reader, 43-year- old Merle C, thinks that it's time for her to seek help from Lifeline.

Merle says she feels tired all the while and this is going on for some years now. She has checked with her doctor and nothing really has been found. She is not anaemic and does not suffer with high or low sugar and has a normal thyroid gland function.

The doctor does not think she has any serious disorder. Sometimes she has a bit of stress and was a bit depressed when her grandmother, who grew her up, died. but that is all, right now. However, she still feels just tired. Her appetite is not good and she experiences problems with sleeping at times.

She also has bad sinus problems but takes antihistamines for this. Merle says she was working part- time but has stopped this as she just feels too tired at times to cope with work. Merle wonders if Lifeline has any suggestions to help her overcome her problems.

If Merle is not feeling better, and especially if she is feeling worse, it is always a good idea to seek a second opinion. Merle should ask her doctor to refer her to a private medical specialist or hospital specialist clinic for review.

Her problems could range from a myriad of disorders including hormonal imbalance or infectious mononucleosis (a viral infection), myasthenia gravis, leukaemia, or a vitamin deficiency, an undetected heart problem, or food allergy, to an undetected chronic depression or other mild-to-serious conditions which will require a good physical check-up and tests to detect and then treat.

It is not possible to determine the cause without this process, which will require more than one visit to the physician!

One condition rarely spoken about is chronic fatigue syndrome, which Lifeline will mention at this time. This is a difficult condition to diagnose and causes a range of symptoms. It is possible diagnosis after investigations do not reveal any other disorder. The main symptom here is extreme and debilitating fatigue and exhaustion for which no other cause can be found. Other related symptoms can include:

Weakness

Muscle and joint aches and pains

Headaches

Loss of appetite

Sore throat

Mild fever

Swollen lymph glands

Intestinal problems

Upper respiratory tract infections

Anxiety

Depression

Difficulty concentrating

Forgetfulness

Sleep disturbance

Temporary memory loss and confusion.

Any combination of symptoms can occur and, depending on the symptoms it can be quite difficult to carry on a normal life. Weakness and lack of energy can make getting out of bed a real challenge.

Just what triggers this syndrome is unknown, but many people with it carry antibodies to the Epstein-Barr virus in their blood. Fibromyalgia and intestinal parasites are also commonly found in individuals with chronic fatigue syndrome.

Some people with this disorder suffer with a chronic low blood pressure while standing and others have problems with their immune system.

Chronic fatigue syndrome can occur at any age, but occurs mainly in people aged 20 to 40. It can last for months to years and can start quite suddenly. In some persons, this condition settles down and then may recur after a while. The condition does usually settle down and allows affected persons to gradually return to a normal level of activity.

Chronic fatigue syndrome is not considered to be a dangerous illness and treating it is really focused on alleviating symptoms, for example non steroidal anti-inflammatory pain killers (eg brufen, advil, cataflam, zerodol, acteric, voltaren, nise etc) for headaches and muscle pain.

A healthy-lifestyle practice is very important. Eating right and eliminating processed foods and sugar, caffeine and alcohol is important. Adequate fluid intake of eight glasses of water daily is needed to hydrate and flush the system. Nutritional supplements are important and a good multivitamin should be taken daily. Vitamin E and glucosamine sulfate supplements are also useful. The use of Chinese or Japanese ginseng may help to enhance energy levels.

With this condition, patience is really a virtue. Be patient. Chronic fatigue syndrome tends to pass and symptoms will settle down.

Write to:

Lifeline

PO Box 1731

KGN 8

AJM